Gram-Positive Bacteria

  • Marc E. Grossman
  • Lindy P. Fox
  • Carrie Kovarik
  • Misha Rosenbach


Bacillus cereus, best known for causing mild food poisoning, has been recognized as a cause of life-threatening infection in the immunocompromised host.1 It most commonly presents in a neutropenic patient as a single vesicle, pustule, or bulla on a digit or extremities with rapidly spreading cellulitis during the spring and summer.2,3 The bulla may become necrotic and develop a black eschar. Lesions may mimic clostridial myonecrosis.4 The lesion is usually painful and associated with high fever and negative blood cultures.3 Gram stain of the aspirate smear or lesional biopsy shows large Gram-positive rods, which may be mistaken for Clostridium infection and treated with penicillin. B. cereus organisms are generally resistant to β-lactam antibiotics and most cephalosporins. The most useful drugs are vancomycin, carbapenems, and aminoglycosides.


Human Immunodeficiency Virus Systemic Lupus Erythematosus Acquire Immune Deficiency Syndrome Necrotizing Fasciitis Bullous Pemphigoid 
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Bacillus Species

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Marc E. Grossman
    • 1
  • Lindy P. Fox
    • 2
  • Carrie Kovarik
    • 3
  • Misha Rosenbach
    • 4
  1. 1.New York Presbyterian HospitalColumbia University Medical CenterNew YorkUSA
  2. 2.University of California, San FranciscoSan FranciscoUSA
  3. 3.Dermatopathology, and Infectious DiseasesUniversity of PennsylvaniaPhiladelphiaUSA
  4. 4.University of PennsylvaniaPhiladelphiaUSA

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